腹腔镜与开腹肝切除术治疗肝癌疗效的Meta分析  

Meta-analysis of efficacy of laparoscopic versus open liver resection for liver cancer

作　　者：佟庆[1] 丁伟[1] 晏冬[1] 王伯庆[1] 薛峰[1] 尹继炜[1] 

机构地区：[1]新疆医科大学附属肿瘤医院肝胆胰外科,新疆乌鲁木齐830000

出　　处：《中国普通外科杂志》2015年第1期27-33,共7页China Journal of General Surgery

摘　　要：目的:系统评价腹腔镜肝切除术(LLR)与开腹肝切除术(OLR)治疗肝癌的近、远期疗效和安全性。方法:检索相关期刊、资料、会议文献和学位论文数据库,收集比较LLR与OLR治疗肝癌疗效的病例-对照研究。按MOOSE规范对纳入研究进行分析,提取数据并用Rev Man 5.3软件对数据进行Meta分析。结果:最终共纳入15篇病例-对照研究,共1 246例患者,LLR组499例,OLR组747例。Meta分析结果显示,LLR组与OLR组的手术时间,1、3、5年生存率,1、3、5年无瘤生存率,3年肿瘤复发率组间差异均无统计学意义(均P>0.05);LLR与OLR相比术中出血量少、术后并发症发生率低、围手术期死亡率低、术后住院天数少(均P<0.05)。结论:LLR可以达到与OLR同样的根治效果,两者近、远期疗效无明显差异,且LLR围手术期不良事件少于OLR。Objective： To systematically assess the short- and long-term efficacy and safety of laparoscopic liver resection（LLR） and open liver resection（OLR） for liver cancer.Methods： The case-controlled studies comparing LLR and OLR for liver cancer were collected by searching the relevant databases covering scholarly journals, materials, conference proceedings, and dissertations. Data from selected studies were analyzed according to the MOOSE guidelines. After data extraction, a Meta-analysis was performed using RevM an 5.3 sot ware.Results： Fit een case-controlled studies were i nally included, involving 1 246, with 499 cases in LLR group and 747 cases in OLR group. The results of Meta-analysis showed that there was no significant difference between LLR group and OLR group in operative time, 1-, 3-, and 5-year survival rate, 1-, 3-, and 5-year disease-free survival rate and 3-year recurrence rate（all P0.05）, while the intraoperative blood loss, incidence of postoperative complications, perioperative mortality and length of postoperative hospital stay were significantly reduced in LLRgroup compared with OLR group（all P0.05）.Conclusion： LLR of ers the same radical resection for liver cancer as does OLR, with a similar short- and longterm efficacy but reduced perioperative adverse events.

关 键 词：肝肿瘤 肝切除术 腹腔镜 病例对照研究 META分析 

分 类 号：R735.7[医药卫生—肿瘤]